Not On PrEP Study

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This research was approved by the Auckland Health Research Ethics Committee on 22 January 2026 for three years (Reference number AH30459).

Pre-exposure prophylaxis (PrEP) is up to 99% effective at preventing HIV when taken as prescribed. Despite this, PrEP uptake in Aotearoa New Zealand remains well below what is needed to achieve national HIV elimination goals.

This qualitative study examines the health system, cultural, and social factors that influence access to PrEP for men who have sex with men (MSM) and their sexual partners — the population most affected by HIV in Aotearoa New Zealand. The project will involve interviews with MSM, and trans, takatāpui and non-binary people who have sex with MSM, who are eligible for PrEP but not currently using it.

About the study

The ‘Not on PrEP?’ study is part of a broader qualitative research programme within the Gay Men’s Sexual Health (GMSH) research group that examines how HIV prevention operates in real‑world contexts. This study focuses on the lived experiences of people who are clinically suitable and willing to use PrEP, but are not currently accessing it, exploring the social, structural, and health system factors that shape prevention access and uptake.

Using in‑depth qualitative interviews, the research investigates how prevention pathways are navigated in practice and why barriers to PrEP access persist, despite strong evidence of its effectiveness. By focusing on issues of access, service navigation, and system‑level constraints, the study aims to identify where current prevention responses fall short and where interventions could be strengthened. Although funded outside SPOTS, the study aligns closely with and complements SPOTS research, generating findings that highlight contemporary programmatic gaps in HIV prevention.

The main aims of the study are to understand why people are not taking PrEP, even if they might benefit from it. It will:

  • Identify barriers to accessing and using PrEP

  • Explore factors that support or hinder PrEP uptake

  • Generate practical, evidence-based strategies to improve access and equity

We are conducting this research in partnership with Burnett Foundation Aotearoa (formerly the New Zealand AIDS Foundation). This study is funded by the Burnett Foundation Aotearoa Research Fellowship. 

Findings will inform:

  • Targeted interventions to improve PrEP uptake

  • Clinical and community guidelines

  • Policy and system-level changes to strengthen HIV prevention

By addressing gaps in PrEP access, this research supports Aotearoa New Zealand’s goal of reducing HIV transmission by 90% by 2030.

Who can take part?

You can participate if you:

  • Are aged 16 and over

  • Currently live in Aotearoa New Zealand

  • Are a gay or bisexual man, or a trans or non‑binary person who has had sex with men

  • Meet the requirements as being suitable for PrEP*, and are willing to take it, but not currently on it.

*You may be considered at elevated risk of HIV if, for example, you have had condomless anal intercourse with casual partners, recent diagnosis of rectal gonorrhoea or chlamydia, or syphilis, methamphetamine use

What participation involves

Participants will take part in a semi-structured interview lasting approximately 1–1.5 hours. Interviews provide participants with space to reflect on their experiences with PrEP, barriers and facilitators to access, and HIV prevention.

Participants will receive a $50 koha in recognition of their time and contribution.

Interested in taking part?

For any questions about the study, contact Dr Brooke Hollingshead at brooke.hollingshead@auckland.ac.nz.

For more information, check out the Participant Information Sheet or sign up for a call back via Qualtrics.